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#14 – ApoE4 Case Study: One Man’s Journey to Prevent Alzheimer’s Disease with Gerald Holbrook

If you follow nutrition trends, you know “fat is back.” Arguing that carbohydrates and sugar is at the root of all illness, an army of influencers want you to eat a diet higher in fat. While it is true that saturated fat has been improperly demonized, the one size fits all approach to nutrition doesn’t work for all of us. Studies like Retterstøl teach us that the response to a high fat diet will vary tremendously based on genetics and lifestyle factors. In the latest episode of the Gene Food Podcast, we talk to ultramarathon runner Gerald Holbrook. After receiving a Gene Food custom nutrition plan and learning he was an ApoE4 carrier, Gerald changed his diet away from a high fat Paleo style diet to the Gene Food Lean Machine diet, which is a diet high in monounsaturated and polyunsaturated fats, but very low in saturated fats, especially from animal sources. As a carrier of the APOE4 gene, Gerald is particularly interested in maintaining his cognitive health and staving off Alzheimer’s Disease. We discuss the way he was eating before finding Gene Food, how his diet changed, blood work before and after (Gerald’s LDL-C dropped by over 100 points), and more generally how much of a struggle it can be to carve out a personalized health regimen in the face of so much pressure from different camps of influencers. You can read Gerald’s case study here. This was a very fun episode to record, we hope you enjoy it!

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This Episode Covers:

  • Gerald’s early nutrition influences and his transition to a Paleo diet [8:30];
  • Gerald’s successes on Paleo [13:00];
  • When Paleo stopped working for Gerald [18:00];
  • Gerald’s new diet and how he changed what he was eating [22:00];
  • Gerald’s LDL-C drops by 100 points and other big changes [28:00];
  • Aaron runs through Aaron’s genetic profile and highlights why he was scored how he was [31:50];
  • The problem with nutrition influencers [38:00];
  • Gerald’s excellent carbohydrate genes [40:00];

Alzheimer’s blog posts

We have two long form posts posts on diet and Alzheimer’s:


Gerald: My endurance just took off. Honest to goodness, I told you guys at the beginning of this interview that I ran 24 miles this past Sunday. I could have ran, yesterday I could have gone out and ran yesterday. And you know being a 59-year-old man, I have no pain, no inflammation, no knee problems, nothing. And my endurance just took off. I mean, my endurance has shot through the roof.

John: Welcome to “The GeneFood Podcast.” I’m your host, John O’Connor. Hey guys, today we have a different type of episode than what we’ve done in the past. We’re actually doing a case study. Many of you are interested in preventing cognitive decline, dementia, and Alzheimer’s, and we have had a lot of interest and questions about ApoE4 specifically. For those of you who don’t know, ApoE4 is a gene that increases your risk for Alzheimer’s as you get older, doesn’t mean you’re gonna get Alzheimer’s, but it has been shown to increase risk. And so we have an opportunity today to speak with Gerald Holbrook. Gerald is an ultra-marathon runner in the Houston area. And he has done a GeneFood panel. He’s changed his diet according to his genetics and one of the big markers that he has an eye on his ApoE4 status.

So we’re gonna get into the details of why we selected the diet we did for Gerald. We have Aaron, who’s our head of research and geneticist on the show, and he gets into the individual markers that we used to categorize Aaron the way we did and we put him on a diet that’s very low in saturated fat. And we have before and after bloodwork. So we talked about what is bloodwork look before when he was on a different style of diet and what his blood looks like now that he’s on a diet that we see as being more suited to his genetics. It’s an interesting, deep dive into one person’s story about how they’re eating, how they’re trying to protect their brain as they get older. I think you’re gonna enjoy it. There’s a lot of good information here. And we hope that you can use Gerald’s story to find out what works best for you in your journey towards health and wellness. So without further ado, here is Gerald.

So for those listening at home, we have three people on the call today, we have Dr. Aaron, those of you who have listened to episodes in the past know Aaron, he’s been our regular guest on the show. He’s the head of research and geneticist at GeneFood. And he’s here he’s gonna do some genetic analysis of Gerald’s charts later in the show. And of course, we have Gerald Holbrook who’s an ultra-marathon runner, family man, and athlete in Texas. So, Gerald, you are someone who’s been a long-time runner, I believe, is that correct?

Gerald: Well, I’ve been doing ultra-marathons probably since about 2010.

John: Okay.

Gerald: I did the Leadville 100. And so yeah, since about 2010, but I’ve been running competitively since I was in my 20s and I took a break in my 40s and then I decided once I reached my 50s, I wanted to get back into doing some more running events. And so my daughter sent me a book, “The Ultra Marathon Man,” I read the book “Born to Run” and kind of got inspired to do hundred-milers and ultra-marathon runs after competing in 5Ks and various marathons and events like that. So yeah, I started doing ultra-marathons.

John: So when you were running in your 20s, were you running on a college team or something? Or how did that…?

Gerald: No, I didn’t run in college, but I did run for a sporting goods company that was sponsored by Nike. And so there was a few invited individuals that would be picked up in the regional area and we would go to races and compete against other local companies. And we would be sponsored by the sporting goods company and then we would wear their shirts and wear Nike gear, and we would go around the areas and we’d win these races. I would be in 1st, 2nd, or 3rd in these typical races and did that for about 10 years, competing, and I mean, I continued to race but work and family got in the way. So I wasn’t able to compete in those type of events anymore, but I still competed. But I was moving around the country at that time.

John: Gotcha. So you took a little hiatus maybe when your kids were younger?

Gerald: Yeah. I took a little hiatus. Actually, after my…I ran a marathon in Detroit, the Detroit Free Press Marathon where you run underneath the bridge from Canada to Detroit. And I did that and then I kind of retired as far as competing in races at that point for about, I’d say for about eight years. I just I mean, I was still working out every day. I was still lifting weights, and everything but I just kind of got burned out on just doing the races every weekend. So from about 40 to 50, I kind of stopped until I got inspired again to start doing ultra races along with my weight training. I always did some weight training along with cardio at the same time, but I did take a little break from the competitive races in my 40s.

John: Cool. Actually, I’m from Detroit originally, grew up in the suburbs of Detroit. So that marathon that goes…so it goes across the Ambassador Bridge?

Gerald: Yeah.

John: Cool. So you basically loop through Windsor and then you…

Gerald: Well, they bus you over there and they start you over in Canada and then you run underneath, the tunnel underneath the Detroit River.

John: Oh, okay, cool.

Gerald: Yeah. And so they do that, and then you finish in downtown Detroit. It’s a cool marathon. Yeah, I was really disappointed in that race. I was shooting for a sub-three-hour and I finished up…I made the mistake of wearing some brand new racing flats thinking I was really gonna break my all-time best. And I ended up running like a 3-hour-and-11-minute marathon. But yeah, I was disappointed because I was like a sub-2:45 that at 20-mile mark. But I had blisters and the shoes didn’t work out correctly like I thought, so.

John: Yeah, Detroit’s come a long way. For people listening at home that aren’t familiar with the geography of Detroit, it sits right across the Detroit River from Canada. So like, as a kid growing up in Detroit, we’d always go across to Windsor because the drinking age was 19. You know, so we’d go over there. And it’s a little bit of a different story these days. I don’t think people are doing that quite as much. Really since 9/11, it’s been a little bit harder to kind of go back and forth across the border, but…And Aaron, the U.K. citizen on the call, when you do your next trip through the U.S. you might wanna pop in and check out Detroit because it’s kind of an up-and-coming city right now. Its the first time you can really say that credibly in the last I don’t even know how long but you guys can maybe put it on the list. Not the most scenic, but it’s kind of cool. Kind of worth seeing.

Dr. Gardner: Yeah, you see loads of stuff, you know, about all the old, abandoned factories and everything. It looks pretty, you know, amazing stuff to see.

John: Yeah. And thanks to Dan Gilbert, it’s making a comeback. But at the time Gerald ran that marathon, it wouldn’t shock me that the Detroit Marathon could burn you out on marathons and kind of put you into a marathon remission based on the state of the city, I’m imagining at that point in time. But, okay, cool. So you’ve got this kind of semi-pro relationship with marathons. And then the way that we linked up is you are also somebody, Gerald, who has an interest in genetics, you’ve done a GeneFood panel, and you’ve discovered that you have…do you have one or two copies of ApoE4?

Gerald: I just have one copy.

John: Yes.

Gerald: I’ve got the 3,4.

John: Okay, so you’ve got one copy of ApoE4 and you, obviously, as a high-performance athlete, somebody that’s doing pretty incredible things with running, we’re really interested in nutrition. So tell us about your nutrition journey, you know, things you were reading, kind of where you were a few years ago, and what your nutrition regimen looked like for your training.

Gerald: Okay, so my nutrition was kind of influenced in my 20s by a book, “Diet For a New America,” by John Robbins and Dave Scott. A lot of the triathletes back then were vegetarian. So for probably 20-some years, I’ve had a vegetarian diet, but along with that was also…it included a lot of berries too. So I did that for like 20-some years. And then I started reading about Dr. Lauren Cordain, how I was missing out on some protein. And so I started adopting the Paleo diet, you know, started leaning toward more of the grass-fed beef and the pastured chicken. And this was way before I had my genetics tested too. But I just started looking into that I’ve kind of tried to fill into more of a Paleo diet after that.

John: Okay. And so I mean, what did that look like in terms of a day of eating?

Gerald: So like, for me, typically, during that time of eating, before GeneFood but I would do eggs and bacon in the morning…

John: Right.

Gerald: …for breakfast. And then for lunch, I was eating like a big salad with either grass-fed beef or wild-caught salmon. Or I would do some kind of vegetable medley with maybe some pork, you know, that I would cook. And then dinner would be, again, another type of protein with vegetables included. So and then also along with that, there would be lots of coconut oil, lots of grass-fed butter, carry [SP] goat butter, I was into that. And then also for breakfast, before actually I ate the eggs and bacon for breakfast, I was into the Bulletproof coffee with the MCT oils. And so I was consuming that before my weight workout in the morning. That was a typical breakfast for me.

John: The “Diet for a New America” book is such an interesting book. I think the author of that book is actually one of the heirs to the Baskin-Robbins fortune.

Gerald: That’s it.

John: Yeah.

Gerald: Yeah, that’s it.

John: And that book is a very, very, very strict plant-based book. So it sounds like you…did you move away from the vegetarian diet because you noticed something about that wasn’t working for you? Or was it because you were influenced by a kind of this new momentum out there conversationally about how, you know, maybe certain types of fats are healthier? Like what was it that kind of pushed you away from the vegetarian diet?

Gerald: Well, no, I think it was just more the conversation that the Paleo diet will be the diet that we all should be eating that we’ve moved away from the ancestral type of food that we should be eating, it would be closer to what we should be eating. So I kind of fell into the science behind the diet. And you had some charismatic people on the internet at that time very first with Mark Sisson and Robb Wolf. A lot of those podcasts and I kind of thought that, you know, there was some good science with it, you know, that it lowers your blood sugar, that your LDL wasn’t that important, your cholesterol wasn’t that important. It was all about controlling your insulin levels. And so I kind of bought into that hook, line, and sinker. So and I just went along with that. And I will say that the first time I went over to that type of diet, I immediately started gaining a lot of muscle, I guess with the amount of protein. But I did put on about 20 pounds in the course of changing my diet with that style.

John: And did you feel that increase in muscle…that feels good, I would imagine, right, you feel stronger, you feel a little better in your clothes kind of a thing.

Gerald: I did feel better at first, I will say that at first. I would say those first couple of years, I really did. Because it was kind of a combination where I wasn’t pounding so much on the…you know, so much running. I was kind of geared more to the weight training, and it kind of just all fit together, I thought, and for the first couple of years, you know, for maybe 20-some years of not concentrating on running all the time, it really…I felt better for the first couple of years, honestly, I did, I thought I kind of maybe put on some muscle, maybe leaned out a little bit. And I was just putting on lean muscle at that time, but it kept on growing and I kept on getting a little bigger.

John: Yeah, I mean, that’s something that we talked about last week. We had on Amber O’Hearn, who’s the founder of the Carnivore Diet Conference, and we were talking about, you know, the trade-offs that come with some of these diets. I mean, the beautiful thing about what we’re doing here today, and what we’re attempting to do at GeneFood, is we’re trying to be basically agnostic as to all diets. I’m sure there’s people that will go and…I mean, I’m confident that there’s people that will go on a Paleo diet and not have the reaction that we’re gonna talk about with you here in a minute and do just fine. Some of them are probably listening right now. And if that’s the case, you know, more power to you. I think the goal is to kind of try to get some frameworks in place for, like, when is somebody gonna potentially do well on a Paleo diet when aren’t they?

Gerald: Well, I wanted to say one of the things that’s important to mention too, though, is when I adopted the Paleo diet, that was the time that I actually 100% eliminated all of the dairy that was included. So that was also an exclusion that, you know, I wanna make sure that I point that out because even when I was vegeterian, I was kind of like [inaudible 00:14:59] vegetarian where I would actually have…I still found…making sure I had enough protein. So I could drink whey protein. Sometimes I’d have skim milk with grains and stuff. So that would be…I still did that. But when I went Paleo, I left all the dairy out completely.

John: Yeah. And that’s one of the things, just I mean, you and I are in the same boat because I’m right there with you. I mean I can 100% relate, like, I like listening to Mark Sisson interviews. I like listening to Robb Wolf. Those guys are both…first of all, they’re in great shape, they look great. They do their research. The place that we part company with those guys is they do advocate very aggressively for one size fits all diet for all people, I think that’s fair. You know, you go on some of these websites, it’s like Keto, the guide to Keto, there’s never a single caveat listed. It’s just it’s gonna work for everybody.

And the thing that’s so challenging out there for people like you and I that are trying to figure out how to eat is I can 100% relate to what you’re saying, which is you hear a really, really convincing commentator, somebody who really knows their stuff. You know, they’re talking about this notion of “the science,” the science says this, the science says this, you have to have MTC oil for mitochondrial function, anybody that doesn’t know that is an idiot. And you finish listening to one of those podcasts or listening to that content on YouTube and it makes you want to run out and buy MCT oil and start loading up your freezer with grass-fed beef and basically that’s just how you should eat it. If I listen to Anino Ticole’s [SP] interview, you know, I’m more likely to order a frickin’ grass-fed steak the next time I’m out eating, right? Because you hear these people’s voices kind of in your head as you’re making food decisions.

Gerald: A hundred percent, hundred percent.

John: It’s so funny how we can fall under the spell of the people, of the influencers that we listen to. Influencers are called influencers for a reason, because they have a shitload of influence over what a lot of people do, you know, both consciously and unconsciously. So I hear you 100% and I’ve been there myself. The interesting thing, though, is the caveats and kind of the warnings are not usually mentioned. And what we’re gonna get into now is kind of this awakening you had genetically where you realize that you had this ApoE4 snip, which is a gene that’s associated with a greater risk. It doesn’t mean…Aaron will get into this in a minute. It doesn’t mean you’re gonna develop Alzheimer’s. It just means that you have an increased risk and our view here is that that snip, in concert with some others we’re gonna discuss that you carry because you did a GeneFood panel, puts you at a position where a diet that’s high in saturated fat is probably not such a good idea. We talked about the good part of Paleo for you. What did you notice when it started unraveling a bit like on a day-to-day?

Gerald: Well, I kept on like that. As time went on, I could never lose any weight. And I also felt a little bit like I had some inflammation and I just thought I’m not strict enough with my carbohydrates. I would just keep rolling around with this, you know, well, I need to cut it out, I need to cut it out more. And I was still exercising, I was still running, I was still lifting weights. And then I could go for a few days and then I’d have to introduce some carbs, some potatoes, or anything and I would feel a little bit better. But then I also notice that I never, ever had any kind of issues with my blood pressure. And I noticed that, like, whenever I get some physicals, work physicals that I was starting to creep up my…I was just kind of, “I can’t believe that.” Like, “I can’t believe blood pressure was starting to creep up.” And I mean, even though like I probably still wore the exact same pant size, I felt I just look swollen. As far as in my face, I felt bloated. You know, and also, in the last couple of years even, my sleep was starting to be affected, which eventually led me to get tested, to get my genetics tested. And that was the big eye-opener right there.

John: Yeah, we’re gonna get into that in a minute. And, you know, we’re gonna mention this a few times in the podcast.

Gerald: And one of the things, like when I was getting my bloodwork, I consistently…you know, I would get my bloodwork and I noticed my cholesterol just kept climbing up. And my LDL markers kept climbing up. I was like, “Well, that’s not supposed to be there.” And, again, then I would do some research. And then I would hear a lot of the common theme is, “Just ignore the cholesterol. You know, that’s not truly a marker.” So there was a lot of noise out there doing some research that it was confusing, but I just feel like some things were happening, you know, my cholesterol was rising and my blood pressure continued to increase. And also, one of the other things was that when I was trying to build my mileage back up, I noticed I couldn’t do it anymore. I didn’t have the endurance that I used to have. So those three things is what I noticed with big things.

John: Yeah, and that’s the crazy part about this whole thing is that you find that these issues are starting to kind of creep up on you. Sounds like you knew intuitively, and also just subjectively based on data you’re getting, that there are these issues that you’re having. But the problem is, is you kind of go back to your community that you started to trust, which is you know, in some cases, it’s gonna be people that are on a vegan diet, they’re not doing well. I mean, today, we’re gonna highlight how in some cases going on a strict Paleo diet like you’re doing that’s high in these fats, it just doesn’t work for people. Look, Aaron and I have talked about it on previous episodes. I think that’s also true of vegan diets. And we’re not here to selective criticize one diet. This is just an incredible story that you have.

But I think the lessons of your story kind of span beyond the borders of any one diet because I wanna just get more into this idea of you had these issues that were developing and then you went back basically to your community almost to like virtually ask like, “Okay, well, I’m having these issues. What does Paleo influencer one, two, or three have to say about this?” And they never will concede that it could be their diet. They’re just like, “Oh, people have cholesterol that goes up on this diet. Oh, cholesterol is not dangerous. Those studies are just bullshit. Oh, people’s blood pressure’s going up on Paleo. Oh, you just need more salt. We have a supplement we’re selling. Here, take more salt. That’ll fix it.”

Gerald: Right.

John: That’s what I hear you saying is that you went back and they have all the rebuttals ready, whether it’s the vegans, they’re just like, “Well, no,” rebuttal ABC, all that science. You know, it’s just bullshit, that that doesn’t exist. Was that your experience? Is that the first place you went?

Gerald: Yeah, no, that’s exactly right. And that’s why it was like I was in this vicious cycle. And I couldn’t get the results that I got at the very beginning and they were getting worse. And I felt like I was actually getting…I felt like I was getting old, right, for the first time. And I know…and again, I’m like you, John, I don’t criticize any other diets out there. But I was just trying to find something that was gonna work. I was trying to figure out what was gonna work with me because I knew my body for so long and I’ve been an athlete my whole life but I knew something was not right. I wasn’t feeling as good as I used to feel.

John: Yeah, look, I wanna say before we get into this piece, the genetics piece of this equation is one piece of the puzzle. You have genetics. We believe at GeneFood that it’s important piece, it’s at the foundation, it’s not the only piece. Aaron, who’s gonna weigh in here in a minute likes to say that, “Look, we’re just scratching the surface of kind of the potential of these genetic markers.” Having said that, if you make the analogy of the entire genome is basically the highway across the entire country from New York to L.A., these snips, these genotypes that we’re gonna talk about are basically the major cities. So they’re better mapped, they’re known quantity is along the road. There’s a whole bunch of cities that we have yet to discover that could become boomtowns and could build up and be, you know, overnight Gold Rush cities that we’re gonna be talking about in the future. And I wanna have some humility as I delve into this topic and not say, “Oh, it’s all genetics, everything’s genetics, that’s all you need to know.”

Gerald: Right.

John: But having said that, the genetics is definitely a piece of the puzzle, there definitely is good science there, we definitely can use it as a foundational tool. And if you’re somebody like Gerald, who then goes and does the work of truly digging in, like we’re about to talk about with your labs, and you pair the labs with the genetics, you are well on your way to developing something that’s a pretty cool personalized regimen. So you come to GeneFood, you’re eating Paleo, and your results come back. Tell us about your experience, basically, in terms of, like, what your reaction was when you saw our diet type that you got.

You were put into the lean machine category of our diet type. We have basically a Myers-Briggs of nutrition. So lean machine from 10,000 feet is high-fat diet except for, you know, MUFA and PUFA, monounsaturated fat and polyunsaturated fat, very low saturated fat diet, you’re very likely lactose intolerant, so the dairy wasn’t gonna work. And you have a little more wiggle room in terms of your insulin response like your carbohydrate clearance. And so you probably are somebody that does have more room for a diet that’s higher in complex carbohydrate. So just to set the table for people that don’t know. So anyway, tell us your experience in terms of how you reacted once you saw this information.

Gerald: Well, when I saw it, it was like the light went off because when I kept noticing that my cholesterol continued to rise, and I would look at the only way to really, you know, lower cholesterol. And so I came from this background, you know, I needed cardio [inaudible 00:25:02] of the world and I’ve read all of his books. And I thought, “Oh, my goodness, I left with so much strength,” because I felt really good on that. But there was a component from the report, like, you know, I should cut out dairy. And that I do well with polyunsaturated fats. And then I can also get by with eating maybe a higher glycemic food and all of those things. I knew that deep down inside, my intuition, I knew that I did well on those things, they never bothered me. And so it wasn’t a shock to me but it was like a revelation. Right? It was kind of like, “Golly, my intuition was talking to me, telling me that’s what I should eat.” And I immediately went in 100%, I went full boar. And probably for the first two months, I guess, I didn’t eat any kind of animal products at all. I just stayed strictly to, basically, lean machine recommendations.

John: Except, just to interrupt you there, the lean machine is…the diet type is not a vegan diet type. It definitely…

Gerald: No, it’s not, it includes like 10% of like wild salmon.

John: Yeah, absolutely.

Gerald: But I just wanted to kind of…I was really wanting to look at some markers. So I had the cholesterol marker, so I wanted to see if I could really flip this around, right. So I started eating that way and I immediately started losing weight and, John, I was eating continuously, there was no caloric control. I could eat as much as I wanted and people were just amazed at the size of breakfast I was eating. Like I would eat a cup of rolled oats, a cup of blueberries, an apple, a banana. I was having flaxseed in that along with oat milk. That would be like a typical breakfast, it would be like a 600-calorie breakfast, you could say. And then lunch was egg salad with like garbanzo beans. Dinner was maybe four slices of Ezekiel bread, it was four servings of black beans or lentils, something along those lines, and sweet potatoes or regular potatoes. For those in the typical diet, again…and then I started to…so that was the first couple of months and then my cholesterol dropped, like 175 to like 131 within two weeks on my LDL.

John: I have your charts here that you sent us. It looks like actually at your peak under the Paleo diet, it was 192 milligrams per deciliter and it dropped to 88.

Gerald: Yeah.

John: And when we saw those numbers internally we were like, “Oh, okay, well, he must have been statinized too, I mean, but you said you didn’t take a statin and it dropped.

Gerald: Oh no. I have never taken a statin.

John: Yeah, so dropped over…from your peak, it dropped over, looks like, 100 points in your LDL cholesterol. And we have your Apo B number. For the people listening at home, apolipoprotein B. There’s one Apo B protein for every LDL particle. So if you know your LDL particle number, that’s great. If you know your Apo number, you basically know your LDL particle number. So his Apo B was 73, which puts you, I think, at an LDL particle somewhere like around 900, which is really cool. And even as I hear you saying that, like, you know, I think to myself, you’re talking about basically going and doing it basically being an athlete that’s running on glucose and stored glycogen, kind of in the old school swim team model. And there’s some many influencers on the internet who are like just so dismissive of that now, and you start hearing that and it influences how you wanna eat unless, in your case, it works for you. So we’re gonna bring in Aaron here. I wanna talk about like some of the genetic markers. But what else do you have to add to this kind of transition, Gerald, before we kind of talk about, in our scoring system, why we assigned you to this diet?

Gerald: Okay.

John: You and I have kind of worked together offline as well. And you’re also very, very focused on the ApoE status and basically doing what you can for your cognitive health.

Gerald: I’d like to make a point, again, I started incorporating the wild salmon to make sure I was protecting DHA amount that’s going into my brain. So I know there’s some scientific literature that’s come out, you know, that DHA is important for people that do have the ApoeE4. So I did start including…I kind of eat wild salmon almost like a supplement that I have at least two days a week. But as I told you, I did get my omega 3 index tested this past Saturday. So I guess I’ll find out whether or not two servings a week is enough or if I need to move up even more than that.

John: Maybe some cod liver oil, algae oil, or whatever. And then also just for the people that are kind of saying…because there is a camp of people that don’t believe that LDL is causal in heart disease and they don’t think that a cholesterol of 260 or an LDL cholesterol of 192 milligrams per deciliter, which is really, really frickin’ high, is something to worry about. Your blood pressure also came way down.

Gerald: Oh, yeah, my blood pressure dropped to like 155. So like when you saw…I sent you a picture of, like, it was like 110/70 yesterday.

John: Yeah.

Gerald: Yeah, my blood pressure dropped [inaudible 00:31:02]. Those are all important markers eating into the protection of Alzheimer’s. That’s what I look at as my biggest risk for the next 10 years is protecting blood flow, my lipid profile, and my cognitive health.

John: So what we did in preparation for the podcast is Aaron…we looked at your charts. And basically, Aaron picked out some of the highest science score markers in your charts that would explain why because again, we wanna have a framework here, you know, some people, it could go the other way. We wanna try to have an explanation as best we can with what we know, which is not everything, why that’s happened in your body. So Aaron, do you wanna run through some of these markers that we flagged and kind of explain with Gerald why he was scored how he was?

Dr. Gardner: Yeah, sure. So one particular sort of thing that you’ve talked about at with John there is your aort of switch away from saturated fats towards…you know, reducing your saturated fat intake, but keeping those high-quality…the wild-caught salmon to get your EPA and your DHA and things like that. And that’s quite a big part of our diet plan. And so looking through your saturated fats next, there was a couple that really jumped out to me. And the one that really, really jumped out is the ApoA2 or the apolipoprotein A2. So this is a protein that forms or is a component of HDL particles in the blood and it’s thought to stabilize their structure. And the snip in particular that we’re interested in is Rs 5082. And the risk scale for that is G and the non-risk is A and you were actually carrying two risk alleles. And if you read in the literature about this, those two risk allelss correlate with increased levels of LDL, increased levels of total cholesterol, and an increased risk of diabetes. And the really interesting bit is that if you have a high saturated fat intake at the same time, this makes those markers even worse.

So it was really cool. When John shared your data with me and we sort of had a look through it, as soon as you cut out that saturated fat, your LDL, your total cholesterol basically, well, more than halved just by cutting out the saturated fat. So it was really cool to see…there’s big studies out there that you can read about and read these effects, but actually seeing it in a person who’s made that dietary change and seeing that huge decrease in your total cholesterol and your LDL cholesterol as well, that was a really cool one to see. So that was probably the most important snip, I would say, on your diet plan to show…you know, to sort of direct which sort of way you were gonna go.

John: As part of the scoring system, like ApoE2 that has a high science score, but there’s also the ApoE4 snip, and then ACE and then also PCSK9, I think we should talk about all those.

Dr. Gardner: Yeah, so ApoE4, you kind of talked about it. And that’s a really interesting one because it has the neurological issues associated with it. And then there are also issues with how you maybe respond to dietary fat. And it’s interesting because there’s a lot of people out there talking about maybe a ketogenic diet being protective for people who have the ApoE4 genotype. And we’ve bounced around this a lot because, obviously, you know, that’s really cool if it’s protective but the other side of it is that it also has quite negative effects that you have a high fat diet as well. So we sort of been trying to figure out what the best way to incorporate this into our diet plan is, you know, and we went the way of basically, you already have this genotype, the ApoE4, which I think you were heterozygous, you have one copy of it.

Gerald: Yes.

Dr. Gardner: Then we would suggest that you reduce your saturated fat intake as a way of, again, controlling your cholesterol and your LDL cholesterol as well. And it seems to have worked quite well in relation to that.

John: And then with the ACE.

Dr. Gardner: So ACE is going in a slightly different direction. So that’s not one of the ones relating to cholesterol. This is one that’s related to your blood pressure. And again, this is really cool how tightly it marries up with what you sort of experienced, Gerald. So just to quickly go over, ACE is angiotensin 1 converting enzyme, it basically plays a key role in regulating your blood pressure. So your body secretes this angiotensin ACE converter into its active form. And this angiotensin then causes things like your smooth muscles around your blood vessels to constrict, it increases your blood pressure, and it stimulates fluid uptake in the kidney. So all of this basically goes together and increases your blood pressure. So there’s one snippet in particular that’s really cool, RS4343, G is the risk and A is normal. And again, you had two risk alleles for that snip.

Gerald: Oh, wow.

Dr. Gardner: And that correlates with people having a higher blood pressure, especially during exercise. But they also have an increased weight, which is potentially due to the fluid absorption in the kidneys.

Gerald: Correct, yeah.

John: And also sodium is contraindicated for that.

Dr. Gardner: Yeah. And the sodium intake as well.

Gerald: Well, that’s exactly how I felt. After a couple of years on that, I just felt like I was carrying around 20 pounds of food. And like I said, I lost 20-some pounds when I changed the diet. But if you saw my waist size, I mean, I still wear a size 30 waist It was still a size 30 but you could tell I lost 20 pounds. But it was like, where were the [inaudible 00:36:53]? It was like it was all just water that I’d lost. It was amazing how different I felt. And also, the blood pressure, how I felt, it allowed me to sleep better at night because the blood pressure actually was…for me, it felt like it was causing some anxiety.

John: So Aaron, mechanistically, in terms of nutritional inputs on that ACE issue, you could theorize that all, basically, the animal flesh like these super high-sodium foods were really exacerbating that in Gerald’s case.

Dr. Gardner: Yeah, I mean, definitely. So we have a little subsection on the thing for micronutrients. And sodium was one of the ones that flagged up as, you know, you should possibly consider reducing. But as part of the wider diet plan as well, by making that transition away from lots of animal products, you probably were also reducing your sodium intake as well. And that’s probably one of the reasons why your blood pressure, again, you know, you went from being on the borderline of having an issue to sort of fitting slap bang in the really healthy blood pressure readings.

Gerald: Yeah, my report said to reduce sodium. So I went all-in, I eliminated all salt. So there was no salt that I was getting like externally, you know, from added salt to food. So the only sodium I was getting was actually included in the food, the whole food, so. So it did, it made a huge difference too.

John: Yeah, and I mean, the thing that’s so interesting about that, just to hearken back to what Gerald and I were just talking a minute ago, is that when you’re out there looking for answers, and you’re looking to influencers for information…and again, look, the Paleo world is the world that we’re highlighting today for one very narrow reason, which is we’re talking about Gerald’s story. I mean, you know, we could have somebody on who was on a strict vegan diet and didn’t do well in it and talk about the reasons for that as well. But so I’m not trying to pick on Paleo, but I hope that there could be somebody listening who could say…you know, who’s maybe not allowing themselves to acknowledge an insight that they may have reached or that’s creeping in the back of their mind and then that’s having that insight sort of stripped from them by very adamant messaging from an influencer or series of influencers because one of the things that the influencer community in these Paleo and low-carb circles loves to do is tell you how amazing salt is for you. That there’s no evidence whatsoever for a high-sodium diet contributing to high blood pressure, it doesn’t exist.

And in fairness, we have a blog post on the GeneFood site about how this can be an issue of mineral balance. But look, I mean, this is something that is subject to individual response. So it is possible that you could be having too much sodium and then that sodium could be causing your blood pressure to rise, that actually is something that’s possible. It’s not bad science. It’s an actual sort of like thing that we can tell based on people’s genetics. So if you have high blood pressure, maybe skip the sodium supplements that the Paleo influencers are selling online. Okay, so what else do we have, Aaron, in terms of the positive genes for the carbohydrate clearance?

Dr. Gardner: Right, yeah. So they was kind of, you know, saying maybe you should reduce this aspect in your diet. But we don’t want people to think that this is all the diet plan is saying you can’t have that, you can’t have that, you can’t have that. We also take into account, you know, your positive snips, things where you do well, and factor that into the diet as well. And one thing that particularly flagged up that John sort of talked about is that you actually could deal really well with a carbohydrate intake. So we see lots of people with their nutrition plans. And they may have snips which predispose them to type two diabetes, or they sort of, you know, have got an insulin response, things like that. You seem to carry next to none of those snips. So things like ADCY 5, which regulates insulin, again, you had a really good score for that. Another one that we’re particularly interested in is Adrine A2. I’m taking together these two snips, but then also all of the other snips we look at in carbohydrates.

We could sort of pull out that you’d likely do well on a plant-based diet, especially one that’s rich in fiber, complex carbohydrates, you’d be able to tolerate this well. It shouldn’t really influence your blood sugar levels significantly. When you do that, you shouldn’t see these peaks and troughs that some people have. And that then factors in putting you on to the lean machine diet where you can bring some of your fat intake down but push the carbohydrate one up a little bit. And that could provide you with a better sort of energy source for all of your endurance running that you were talking about earlier.

Gerald: That’s exactly what I’m seeing.

Dr. Gardner: And then the other thing that ties in as well, and this is a sort of a thing that’s close to John’s heart, is bringing in the sterols, so the plant fats. So we’re currently sort of thinking about this and seeing how maybe a lot of people who bounce off vegan diets or very heavily plant-based diets have issues absorbing these sterols and dealing with them. And looking at your sterol score, you scored well in that regard. So again, this is probably why when you are able to tolerate a quite heavy plant-based diet quite well because you have to deal with the sterols, you’re able to eliminate them properly, you don’t get any of sort of the negative side effects that some people report when they ever have any plant-based diet or some people maybe have bounced off for those reasons. So yeah, looking at it as a whole, there’s some negatives taking you away from saturated fats, but there was a lot of positives pushing you towards the complex fiber-rich carbohydrates as well.

John: And just a riff on that with the sterol issue, it’s pretty interesting when you look at Gerald’s lipid score. Some people listening may think well, what happened to his triglycerides, what happened to his HDL? So from his worst score, in terms of when his cholesterol was 266 and his LDL cholesterol was 192, his triglycerides went from 83 milligrams per deciliter, in the green in most labs, to 97, slight uptick, his HDL went from 57 to 48, slight downturn. But to speak to that sterol issue in terms of what was causing him to have his LDL numbers go out of range, it was clearly that he had very cholesterol-rich LDL particle because of the fact that he had his triglycerides that were in range. And when he started eating a diet that was very plant-heavy, his LDL cholesterol went way down. And part of what’s included in the LDL cholesterol number is not just the actual mass of cholesterol, it’s also the sterol. And so the issue he was dealing with was basically it seems as though, in response to high fat, his body was making a ton more cholesterol.

Dr. Gardner: Yeah, exactly that, John.

John: So that’s the genetic analysis there. Gerald, I think it’s interesting, what you mentioned about carrying the water weight, that’s really interesting.

Gerald: I thought so too. I thought that was…you know, just watching it happen to myself, I thought it was very insightful when I started, you know, removing the saturated fat, but it felt like it wasn’t that I was losing so much body fat. It was like, I was losing so much edema or some so much water weight I was holding, you know. Because I was always heard the inflammation was caused from eating so much carbohydrates and having insulin levels high. Well, that didn’t work with me, it was kind of the opposite, it was almost like the saturated fat was causing inflammation snd that’s what was causing me to hold so much water. Because, again, I didn’t actually go on any kind of a diet whatsoever. As far as calorie content went, I didn’t restrict any calories and I still lost 22, 23 pounds. So to me, that was like inflammation, you know.

Dr. Gardner: So once you’ve made the switch on your diet, how did you find, like, your ability to undertake your endurance runs that you were talking about? Did you see any shift in that?

Gerald: Oh, yeah, yeah, I’m sorry, I should have mentioned that. So my endurance just took off, honest to goodness, I couldn’t tell you. Like, I told you guys at the beginning of this interview that I ran 24 miles this past Sunday. I could have ran yesterday, I could have gone out and ran yesterday. And you know, being a 59-year-old man, I have no pain, no inflammation, no knee problems, nothing. And my endurance just took off. I mean, where before when I was eating the Paleo, I mean, about five or six miles, I was struggling, I had to do like a lot more walking interspersed with my running to be able to, like, get the mileage up. And so I was just kind of thought, “Well, I guess I’m never gonna be able to get my mileage way up there again.” But no, it’s been quite the opposite. So my endurance has shot through the roof.

Dr. Gardner: And do you think that’s just based on that you’ve got more energy or is it like you’re saying that you don’t get those inflammatory issues, that your recovery’s much better as well?

Gerald: Aaron, I think it’s exactly that. I think it’s the inflammatory response that’s taking place. Because I was actually trying to see a podiatrist to try to figure out what was going on in the ball of my foot because I was getting some pain in the bottom of my foot, and it’s completely gone. And so I look at it as more of inflammation has cleared and there’s not an issue with that anymore, to be honest with you.

Dr. Gardner: Yeah, I mean, that’s why I was asking just that information, there’s no real way we can sort of measure it really well, you know, the inflammatory things, but just when you sort of talking about things, looking at your snips, the things you’ve talked about with John, it just immediately in my head was making me think that yeah, your inflammation must just be getting…you know, you must be having a lower level of systemic inflammation.

Gerald: Yeah, I wish I would have gotten my CRP measured before because it’s like, it was below a one, you know, after the fact, but I wish I would have got it measured before I switched over to the lean machine diet. I wish I’d had it before. Because I started really getting so excited, I started getting all kinds of blood tests done to see how good I was doing. I just wanted some documentation just to have some numbers to back it up. I wish I would have had more numbers before, the size of cholesterol and everything.

John: Yeah, but when you did get your CRP down after eating this way, it was really low, if I remember correctly. I don’t remember exactly what it was, but…

Gerald: Yeah, it was below one.

John: I think another thing that you’ve done a really good job, Gerald, that we could kind of close out to give people just some wisdom on is this whole idea of your being very vigilant about balancing your omega 6 to omega 3 ratio as well on a plant-based diet too.

Gerald: Right.

John: Because, again, I really do wanna emphasize and just keep emphasizing this point, we’re not advocating for a one size fits all diet for anyone, we have other diets in our matrix that are very low glycemic. Like a popular diet in our matrix is forager. Forager is a very low glycemic diet, it wouldn’t be the same protocol at all that Gerald’s on. But you know, you’re even paying attention, Gerald, like in terms of the supplements you’re taking to your omega 6 count. Do you wanna speak to a little bit of that in terms of what your outlook is on those issues?

Gerald: As far as the supplements, I am taking some fossil lipid omega 3s. And based on Dr. Rhonda Patrick’s research, you know, that ApoE4s have a hard time getting the DHA into the body without the phospholipids form.

John: Okay.

Gerald: So I have been supplementing omega 3 like there’s one that Nordic sells. But then, really like, I’ve tried fish oil also. She’s a big believer in the fish oil and that’s like double the amount of like a typical wild salmon but I tried fish oil for a while. But also in her report, you know, says that actually just supplementing fish, wild-caught salmon, and I eat a lot of that, but that actually does better with the ApoE4s. I had been doing this regular fish oil too, just the cod liver oil also, but it seems to be, according to the research that I was reading, that the phospholipid is the best source as far as someone with, you know, my genetic makeup. As far as my normal routine, I take an NAC supplement, I take some magnesium at night, I do take vitamin D3. I take vitamin K2. You know, just I watch those numbers with the vitamin D3, I make sure you have enough K2 also.

John: Well, Gerald, this has been a really cool conversation, I’m glad we did this. I really appreciate you sharing your story. I hope that it will help some people that are listening. And we’re gonna keep talking and keep in touch and, you know, be with you on your journey here. And thank you for your time, man. It’s been a lot of fun chatting.

Gerald: Yeah, and I appreciate it. And I would just encourage anyone, again, I mean, what my diet report came out could be completely different from anyone else, but I would encourage anybody to take the reporting and at least look at the template, what it should look like as far as what the genetic makeup is. Because what I get asked all the time as far as like diet, you know, nutrition, and I used to years ago, you know, whatever diet I was on if I was doing well on it, you know, you just want to, “Okay, just match what I do.” But I have abandoned that thought whereas now I believe what you should do is you should get your genetic testing done, then send it in, you know, to find out what it says in GeneFood. And I have actually recommended to several colleagues at work and they’ve been either impressed, surprised, or you know, what they thought they should be eating was completely different. So it’s eye-opening. And I think that’s a great template to start out and see what it could be. And I appreciated Aaron giving me all the advice, I appreciate that.

Dr. Gardner: No worries, it’s been great to talk to you. It’s great when I get feedback from anyone really even if it’s positive or negative. But it’s really cool when you get someone who’s responded so well to the diet plan and having sort of such profound effects. It’s always really cool to hear that.

John: Yeah, I would just close, in support of what Gerald said, it could be GeneFood does, it does not have to be GeneFood. You know, we’re not the only game in town. Of course, I believe in our product, but there’s a lot of people telling you how to eat and as well-meaning as they may be and as much as it may work for them, it might not work for you. And sometimes it’s really hard for those of us that are kind of out there looking for these answers to disassociate from the strong opinions of influencers and kind of go out on our own. And I think that Gerald’s story is a really inspiring example of why striking out on your own and figuring out what works for you can be a very powerful way to take control of your health. So, all right, thanks, guys.

Gerald: All right, thanks, John.

Dr. Gardner: See you later.

John: We’ll talk soon. Yep. Bye-bye.

Gerald: Thank you, Aaron.

John: “The GeneFood Podcast” is our attempt to synthesize the latest developments in the fields of genetics, nutrition, and medicine, and offer you practical tips and stories you can use in your own unique health journey. If you enjoy this podcast, you can find more information online at

John O'Connor

John O'Connor is the founder of Gene Food, a nutrigenomic startup helping people all over the world personalize nutrition. John is the host of the Gene Food Podcast and a health coach trained at Duke's Integrative Medicine Program. Read his full bio here.

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